Expert opinion: Donald Trump does not have a personality disorder

Personality and character are always at issue in a presidential election, as is the sanity of the candidates. When a contender is referred to as a madman or lunatic, the comment is usually understood to be hyperbole.

No one has accused Donald Trump of hearing voices or howling at the moon. However, many have called him a narcissist.

I have qualified in court as an expert in the psychodiagnostic arts. In prisons and in jails, I commonly encounter narcissists, owing to the fact that clinical narcissism is a core component of the psychopathic mind and sociopathic character.

As an expert in diagnosing disturbances of mind, emotion and character, I can state confidently that Donald Trump does not have narcissistic personality disorder – a condition listed in the psychiatric Diagnostic and Statistical Manual.

To start with, a diagnostic label cannot be assigned to an individual without their consent or without legal authorization. No law requires politicians to submit to psychological fitness examinations.

More importantly, Trump does not meet the criteria for a diagnosis.

To qualify as a disorder, a character style must generate clinically significant distress or actual adaptive impairment. The imperceptible line between normal and malignant is crossed only when the character traits cause the individual harm.

Trump has done well in life. He has never been arrested or homeless. He is apparently free from disabling anxiety. Rather than being hampered by his magnified ego, he has validated it and reveled in it. A central rationale for his candidacy is that he is a "winner."

Without symptoms of distress or functional impairment, it cannot be said that Trump has a diagnosable personality disorder.

To understand Trump in psychological terms, the Diagnostic and Statistical Manual is the wrong textbook to consider. The question is about personality dynamics, not diagnosis. Instead, I would suggest a seminal text by J. Reid Meloy: "The Psychopathic Mind."

Psychopathy is considered to be a particular type of narcissism. Blinded by an enduring belief in their own goodness, wonder and rectitude, these individuals fail to understand how anything they do could ever be wrong.

The hallmark of the psychopath is "predatory aggression." At a characterological level, a con artist selling get-rich seminars is just like a guy with a knife, lurking in an alley. The profile also applies to the "aggressively domineering psychopath" – another type of predator, commonly known as a "bully."

According to Meloy, "the psychopath is an imposter." Their projected self-image is a matter of smoke and mirrors. While an ordinary narcissist might feel "a sense of being a fake," the sociopath has no awareness of their false self: "he does not merely play the role, observing the limits of his character, but lives the part, sometimes oblivious to the deceptions promulgated by his behavior."

Characters of this type are not invincible. As Meloy notes, "The psychopathic character is haunted by the shadow of his own grandiose self, for the ways in which he induces shame and humiliation in others may always be done to him."

Psychopaths are particularly vulnerable to "narcissistic injury" – trauma to the ego caused by insult or rejection. The inflated self is sometimes punctured like a balloon. Crimes of passion, in my experience, are often precipitated by an assault on a narcissist's identity. Someone tells them "I'm leaving" or "you're fired," and they go ballistic. Some can be baited with a tweet.

Trump cannot be diagnosed, but he can be compared to the psychodynamic portrait of a psychopath, the type who understands morality, propriety and the world around them through a self-focused lens and a self-indulgent hunger.

This, I should say, is all just opinion. People assert: "he can't sue me for saying that!" My experience is that a psychopath will sue you anyway.